Department of Orthopaedic Surgery, Orthopaedic Sports Medicine Center, University of Ioannina, PO Box 1042, 45110 Ioannina, Greece.
Knee Surg Sports Traumatol Arthrosc. 2012 Apr;20(4):785-92. doi: 10.1007/s00167-012-1902-0. Epub 2012 Jan 24.
The purpose of this study was to test whether rotational knee kinematics during dynamic pivoting activities are predictive of subjective functional outcome (IKDC, Lysholm), objective laxity scores (KT max), and activity levels (Tegner) in patients after anterior cruciate ligament reconstruction (ACLR).
Thirty-one patients with single-bundle ACLR were evaluated prospectively with 3D-motion analysis during (1) descending a stairway and pivoting and (2) landing from a jump and pivoting. The side-to-side difference of tibial rotation range of motion (SSDTR) between the ACLR and the contralateral intact knee was calculated for the pivoting phase of each task. Linear regression models were applied with SSDTR, for each task predictors of the subjective IKDC score, Lysholm score, anterior tibial translation, and Tegner activity level.
SSDTR for descending and landing were predictive of the IKDC subjective score (R(2) = 0.46, p < 0.001 and R(2) = 0.40, p < 0.001, respectively) with "medium" effect sizes and of the Lysholm score (R(2) = 0.13, p < 0.05 and R(2) = 0.09, n.s.) with "small" to "none" effect sizes. SSDTR was not predictive of anterior translation or Tegner activity level (n.s.).
Restoring rotational kinematics during dynamic pivoting activities after ACLR is predictive of functional outcome. The ability of the athlete after ACLR to control tibial rotation during pivoting activities may be predictive of functional outcome.
Case series study. Level IV.
本研究旨在测试在动态旋转活动中膝关节的旋转运动学是否可预测前交叉韧带重建（ACL 重建）后患者的主观功能结果（IKDC、Lysholm）、客观松弛评分（KT max）和活动水平（Tegner）。
前瞻性地对 31 例单束 ACL 重建患者进行 3D 运动分析，在（1）下楼梯和旋转以及（2）从跳跃和旋转中着陆时进行分析。计算每个任务旋转阶段 ACLR 和对侧完整膝关节之间胫骨旋转运动范围的侧到侧差异（SSDTR）。对于每个任务，应用线性回归模型，将 SSDTR 作为预测主观 IKDC 评分、Lysholm 评分、胫骨前移位和 Tegner 活动水平的指标。
下降和着陆时的 SSDTR 可预测 IKDC 主观评分（R²=0.46，p<0.001 和 R²=0.40，p<0.001），具有“中等”效应量，并且对 Lysholm 评分具有预测作用（R²=0.13，p<0.05 和 R²=0.09，无统计学意义），效应量为“小”至“无”。SSDTR 对胫骨前移位或 Tegner 活动水平没有预测作用（无统计学意义）。
在 ACLR 后进行动态旋转活动时恢复旋转运动学可预测功能结果。ACL 重建后运动员在旋转活动中控制胫骨旋转的能力可能是功能结果的预测因素。
病例系列研究。IV 级。
